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e~y: R AL PERMIT <br />Owner; Phone: <br /> <br />Address; <br /> <br />Application is made for: (~/) New Installation ( ) Replacement <br /> ( Addition ( ) Gas Connection <br /> <br />Appliance <br /> <br /> NO, FEE AMOUNT <br /> Base Price 10,00 <br /> Forced air furnace 100 000 BTU ,{~,r less 6,00 <br />Forced air furnace over 100,000 BTU 7.50 <br />Floor Furnace 6.00 <br />Suspended Heater 6,00 <br />Wall Heater 6.00 <br />Floor Mounted Unit Heater 6,00 <br />Heat Pump 6.00 <br />A!r Handling Unii'"'io 10,000,cu. ft. '"' , ........ 4.50 ....... <br />Air Han.,~ling Unit over 10,000 cu. ft. 7.50 <br />Evaporative Cooler 4.50 <br />= Exhaust System Commercial ..... 4.50 <br />Hood and Exhaust Commercial 4.50 <br />Domestic Range Hoods 4.50 <br />Domestic Exhaust Fans & D'r)/er vent.~, 3.00 <br />Domestic Wood Stove 7,50 <br /> Commercial or I"ndustrial Incinerator .... 30.00 <br /> Fire Damper ............. 3'.00 <br /> Gas Water Heater 7.50 <br /> Gas Connection w~o Appliance (1-4 ear'S) 2.00, <br /> ov¢,r 4- $8,00 plus ea. addnl, . .... .50 <br /> Appliance or accessory to any heating dr <br /> Comfort cooling system not covered 4,50 <br /> Other (as ,per Mechanical Code): -- <br /> <br />Please return COMPLETE APPLICATION 4% <br />with the indicated fee.INVEST[GATioNPLAN REVIEW FEEFEE I~ <br />FLEET SURCHARGE <br />TOTAL $ ,~,..~2~.~ <br /> <br />BTU input Floor area <br />Vent Size Fuel <br /> <br />COMMENTS: <br /> <br />I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the <br />Ordinances of Marion County. PERMIT EXPIRES IF WORK NOT COMMENCED WITHIN 180 DAYS. I furtherwarrant <br />that I comply with the provisions of ORS 701.005 to 701.125 because; <br /> <br />( ) I am a registered contractor or ( ) the authorized representative of a registered contractor, <br />( ) The work will be performed by a registered contractor. <br />( /)" I am performing work oG, a property I own or occupy. ~ <br /> <br />SI NATUREOFAPPLICAN /¢ "LDRSBOARDREGISTRATION <br /> <br /> <br />